Acute scrotum in children and the role of early exploration

Objectives: There are many causes of acute scrotum that should be diagnosed and promptly managed because testicular loss might affect fertility. In this study I notified the time of onset of symptoms, time of presentation, management and operative findings to assess the importance of early presentation and early exploration. Methods: Records of 62 consecutive boys under 14 years of age treated for acute scrotum at Prince Rashid bin Al-Hassan hospital in three years (2008–2010) were reviewed. During the period studied all patients with acute scrotum that underwent surgical exploration of the scrotum have been studied. The duration and characteristics of the symptoms, clinical findings prior to operation, the age of the patients and the operative findings were registered. Results: Scrotal explorations revealed 15 cases (24%) of spermatic cord torsion, 30 cases (47%) of torsion of the testicular appendage, 6 cases (10%) of epididymitis, 5 cases (8%) of incarcerated inguinal hernias and 6 (11%) other conditions. In six cases of spermatic cord torsion the testicle was gangrenous and underwent hemiorchidectomy. Conclusion: The relatively high risk of testicular torsion and testicular loss in cases of acute scrotum in children signifies the importance of the early exploration and immediate management.